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Three-dimensional Nasolabial Morphologic Alterations Following Le Fort I
Christopher R DeSesa1, Philip Metzler1, Rajendra Sawh-Martinez1
1Division of Oral and Maxillofacial Surgery, Division of Plastic and Craniomaxillofacial Surgery, and Division of Plastic and Reconstructive Surgery, and Yale University School of Medicine, Yale-New Haven Hospital, New Haven, Conn.
Plastic and Reconstructive Surgery. Global Open
|September 14, 2016
Summary
Le Fort I osteotomy significantly alters the nasolabial region. Combining maxillary advancement with widening yields the most dramatic nasal changes, improving surgical planning.
Area of Science:
- Craniofacial surgery
- Orthognathic surgery
- Plastic surgery
Background:
- Le Fort I osteotomy significantly impacts the nasolabial region.
- Previous research used 2D data and lacked subtype differentiation.
- This study addresses the need for 3D analysis of specific Le Fort I techniques.
Purpose of the Study:
- To 3-dimensionally analyze nasal and lip changes after Le Fort I osteotomy.
- To compare changes from advancement alone, widening alone (surgically assisted maxillary expansion - SAME), and combined advancement/widening.
- To test the hypothesis that combined advancement and widening produce the most significant changes.
Main Methods:
- Retrospective cohort study of 108 Le Fort I patients.
- Groups: straight advancement, SAME, and segmental advancement/widening.
- Pre- and postoperative 3D photogrammetry analyzed using anthropometric measurements.
Main Results:
- All groups showed significant postoperative nasal changes.
- Segmental Le Fort I with advancement and widening produced the most pronounced changes.
- Specifically, alar base width, alar width, nostril width, and soft triangle angle were significantly altered (P < 0.05).
Conclusions:
- Le Fort I osteotomy causes significant nasolabial alterations.
- This is the first 3D study comparing specific Le Fort I techniques for nasal changes.
- Objective data aids patient counseling and surgical planning for Le Fort I osteotomy.
